Miamisburg Historical SocietyVeterans Entry Form

 
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Miamisburg Historical Society

Miamisburg Historical Society
PO Box 774
Miamisburg, OH 45343-0774

 

Veteran Report Form

 

 

Last Name ____________________________       First Name ____________________________________  MI _______

 

Birth Date _____________________________        Place of Birth _______________________________________________ 

 

Date Entered Service ____________________    Date Discharged/Retired ____________________________________

 

Branch of Service ________________________   Unit ________________________________________________________

 

War ___________________________________Foreign Service _________________________________________________

 

Rank __________________________________ Highest Award _________________________________________________

               

Last Assignment _______________________________________________________________________________________

 

Additional Information: _________________________________________________________________________________

 

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If deceased:  Date of Death ________________ Place of Burial _______________________________________________

 

Source of information:  __________________________________________________________________________________

 

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(If individual, give name, address, and telephone number/e-mail)

 

 

Recorded by:________________________________________________________Date:_________________________

 

Please return to: Miamisburg Historical Society, P. O. Box 774,  Miamisburg Ohio  45342

or Market Square Building on Wednesday or Saturday between 1:00 P.M. and 4:00 P.M.

 

 

 

 

 

 

 

 

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